No Pain is Gain

You may have heard it said “No pain – no gain.” However that is not always true. I combat that well know mantra several times a week for certain cases. Many in-depth conversations have developed with my clients because it does seem a little counter intuitive – especially when someone thinks they are feeling “muscles working”. Now with muscle isolation – that is most definitely the case, but not so much when you’re talking about a joint. Do you know the difference between muscle pain and joint pain?

Muscle isolation like let’s say when your doing a weighted biceps curl and if your working near a muscle’s maximum potential, then you should start to feel the muscle burn in the muscle belly. However that is not what you want when you’re dealing with a joint. The funny thing is – how do you know if the pain you’re feeling is a muscle burn or joint irritation – because, interestingly enough, they produce a very similar type of sensation. That is most certainly the case when joints are under mechanical load. So, how do you tell the difference? Location!

Yes, Location! To tell the difference you need to have a fundamental understanding of anatomy. Many patients struggle with understanding anatomy, well, because, it is fairly complicated and does require some study – many patients know some muscles – but very few know much about joints, nerves, ligaments, tendons, fascia, cartilages, menisci, and even blood vessels. I see this a lot in terms of people with back and neck pain, but it applies to knee and shoulder and all parts of the body.

I had a client just the other day that illustrates this example. The patient had pain around the knee with activity.   The sensation she felt was a feeling of weakness. When I asked the patient to describe the weakness, the patient pointed to the front of the knee just around the joint line and was fairly confident she just needed to “strengthen those muscles.” The problem is – there are no muscles right around the front side of the joint line of the knee, mostly tendons and ligaments. So, why did she feel weak there? There is no question strengthening of the quadriceps will be fundamental to her plan of care, but I wanted to take a moment to explain to her that the weakness she felt was more of a joint sensation than just weak muscles.  Her program must include some sore of swelling/inflammation management component since the sensation she is feeling is probably a low-grade irritation of the joint.

To summarize, there is a distinct difference between muscle and joint pain and knowing the difference is key to a successful rehabilitation program whether for an injury and/or proper exercise. The “no pain – no gain” mantra does not apply when the pain or sensation is from the joint. To know the difference an understanding of the underlying anatomy is critical to differentiating the similar sensations that muscles and joints make when they are under mechanics stress. If you have trouble knowing the difference and your combating an injury, then talking with an experienced physical therapist can enlighten your process and speed your recovery. So, remember when your exercising or rehabilitating: Pain – is not always gain!